Father - Daughter Dance Registration

* Required

Father or Guest's Information (Reservation will be held under this name)
First Name *	Last Name *
Email Address *	Home Phone Number *	Father's Meal Choice *
Daughter or Guest's Information
Daughter's Name *	Meal Choice *	Daughter is a Senior
Third Guest's Name	Meal Choice	Daughter is a Senior
Fourth Guest's Name	Meal Choice	Daughter is a Senior

Payment Information
We would like to sponsor a family in the amount of:
Name on Card *
Card Number *
Card Expiry *
Card Type *
CCV Number *
Amount * ($40 x Number of Guests + Sponsorship (if applicable))